Medical Biller

Responsibilities

• Submitting claims
• Posting payments
• Working payor rejections and denials
• Completing follow ups to ensure accurate and timely processing and payment
• Following all applicable compliance and regulatory processes, payer guidelines, and internal policies and procedures
• Ensuring timely and accurate billing of claims via electronic or paper to Medicare, Medicaid, and Commercial Insurances in accordance with policy using primarily Niko Health claim submission software and Salesforce
• Working with all payers to ensure medical claims are being processed timely and paid accurately
• Analyzing and posting EOB payments and denials in all billing systems, ensuring correct processing and payment
• Determining root cause and prevention of future rejections & denials, advising management and appeals team where necessary
• Routing claims and/or balances that are deemed uncollectible to Financial Patient Responsibility Review or Write Off Queues timely and appropriately
• Assisting and communicating effectively with patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible
• Identifying process improvement opportunities and recommending potential solutions to improve departmental workflow
• Assisting with any other duties or projects on an as needed basis

Requirements

• At least 2 years of denials experience
• At least 2 years of billing experience
• Highly prefer DME experience
• 2 years of Medicare, Medicaid and/or Commercial Insurance experience, particularly in HME, highly preferred
• A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as it pertains to DME billing
• Ability to take direction and communicate effectively with customers and employees at all levels
• Ability to thrive in a fast-paced and dynamically changing organization
• Strong work ethic
• Excellent oral